Our long-term objectives are to: (a) improve the health and well-being of informal caregivers and, by extension, the quality of care they deliver to disabled elders, and (b) ensure dementia patients have access to high quality in-home and formal health care. Poor caregiver health is associated with elder mistreatment, decreased patient access to preventive care, and earlier transfer to more costly institutional care. Maintaining the health and well-being of caregivers, therefore, is a major public health policy concern as the population ages. While previous research has examined the prevalence and health consequences of suboptimal medication use in the general population, to our knowledge no study has explicitly examined the magnitude of the problem in two growing and particularly vulnerable populations: older adults with dementia and their informal caregivers. The proposed study will be the first of its kind to examine potentially inappropriate medication use, as defined by the Beer's criteria, in dementia patients as well as in their informal caregivers. The specific study aims are to: (1) describe the nature and extent of inappropriate medication use in caregivers of persons with dementia;(2) identify risk factors for caregiver inappropriate medication use;(3) possess the impact of inappropriate medication use on caregiver outcomes and time to institutionalization of the care recipient;and (4) describe the nature and extent of inappropriate medication use in persons with dementia. The proposed study will draw secondary data from the Resources for Enhancing Alzheimer's Caregiver's Health, 1996-2001 (REACH;Schulz, 2001). The REACH data affords us a unique research opportunity because few caregiver surveys include medication data, include a rich source of caregiver and care-recipient variables, and are of adequate size to study relatively rare events such as inappropriate prescribing. Results from this work will define the scope of the problem in this highly vulnerable population, and will inform future medication management interventions aimed at increasing appropriate medication use in both caregivers and their dependent care recipients. PUBLIC HEALTH RELEVANCE: The project's long-term objectives are to: (a) improve the health and well-being of informal caregivers and, by extension, the quality of care they deliver to disabled elders, and (b) ensure dementia patients have access to high quality in-home and formal health care.